The primary purpose of this research is to test the effectiveness of alcohol abuse prevention strategies targeting high-risk youth in a primary health care setting. These prevention strategies will be based on an- innovative Multi-Component Motivational Stages (McMOS) theoretical model. Specifically, we propose to evaluate the efficacy of a three-phase prevention intervention titled the STARS program (Start -Taking Alcohol Risks Seriously). This intervention will involve: l) a media-related materials prevention strategy in the form of youth Self-Instructional Modules and corresponding audio-tapes; 2) an interpersonal prevention strategy in the form of Health Consultations provided by physicians and nurses; and 3) an environmental strategy in the form of Continuous Follow- up Contacts provided by trained peer health models using incentives for successful behavioral change. This study will employ an experimental design to test the effects of the proposed intervention within a primary health care setting. This study is designed to examine replicable, health care-based prevention strategies. The primary outcome measures to be examined include stages of alcohol use acquisition and change, alcohol consumption patterns, and the use of other drugs, i.e., cigarettes, smokeless tobacco, marijuana and cocaine. Secondary, mediating outcome measures will include the frequency of use of self-control strategies for avoiding alcohol consumption; cognitive and social factors including expectancy beliefs, self-efficacy, influenceability, perceived prevalence of use, intentions to use, and self- regulation cognitions; and alcohol-related health beliefs and motivation to avoid alcohol use. Immediate (l month), short-term (6 month), and mid-term (l year) and long-term (2 year) outcomes will be determined for the prevention strategies.